The skin is the largest organ of the body, and in the baby it represents a large surface area in contact with the outside environment. This contact with the surrounding external environment happens right at birth through a sequence of events ranging from temperature variations, to contact with the ambient air, to contact with the first clothes, and, of course, contact with the first skin hygiene products to remove the vernix caseosa1. From this contact always results a skin reaction that can be neutral or range from mild to severe.
1 A whitish, greasy film that covers the epidermis and protects the baby’s skin
Vernix caseosa contributes to skin hydration, thermoregulation
and acidification of the skin
General characteristics of the baby’s skin
The newborn baby’s skin, although very smooth and velvety, is a skin:
- with low protection capacity against external actions and aggressions
Therefore its barrier function cannot be fully performed making it very vulnerable.
Avoid the use of skin care, moisturizing and nutrition products produced for adult skin as these products do not respect the characteristics of baby’s skin. Especially if the baby’s skin is sensitive and reactive
On the baby’s skin
Baby skin is in functional development; it has higher transepidermal water values2, higher pH value, faster shedding rate, faster rate of moisture loss, and different microbiome3.
It is a more fragile skin, more susceptible to infection, at greater risk of surface heat loss and more susceptible to chemical and thermal damage, it is also more permeable to the topical agents used in your daily life.
This is because the stratum corneum4 as a still incomplete hydrolipidic barrier5 and, consequently, the protective function of the baby’s skin is compromised and more susceptible to contamination and external aggressions.
2water stored in the superficial layers of the epidermis
3cutaneous ecosystem formed by small organisms that develop a kind of protective barrier, keeping the skin pH in balance and preventing the appearance of pathogenic germs
4 superficial skin bed
5 protective barrier that keeps the skin naturally moisturized
The permeability of the skin is due to the low lipid content of the epidermis’ hydrolipidic barrier, which is not sufficient to keep transepidermal water trapped in the upper layers of the epidermis, causing the skin to dry out more easily
Caring for Baby’s Skin
Taking care of your baby’s skin can be very challenging when it comes to hygiene, hydration, nutrition and protection of your baby’s skin. What seems like a simple task from a theoretical point of view can quickly become a major concern when you realize that your baby’s skin is reactive and requires more care than you might think.
It is essential to use specially formulated products with ingredients that minimize the risk of reactions on the baby’s skin, such as activating eczema or promoting contact dermatitis. These products should contribute to the homeostatic balance6 of the hydrolipidic barrier7 of the stratum corneum8 by promoting its integrity and reinforcing its protective role against external aggressors.
The main moments of baby’s skin care are bath time, moisturizing and nourishing the skin and changing the diaper. For each of these moments, and particularly for babies with sensitive and reactive skin, suitable products should be chosen.
6 dynamic balance, which ensures the maintenance and physical and physiological integrity
7 protective barrier that keeps the skin naturally hydrated
8 skin surface bed
Remember that every little body is different from the other, and what works for some babies may not work for others. Even with babies in the same family.
The baby’s bath should be done in a calm and quiet way, with water as tepid as possible and washing products formulated with non-ionic surfactants9 should be used, which in addition to being non-aggressive allow the skin’s pH to remain unchanged. They should be suitable for use on the whole body and face and be ophthalmologically tolerant. Although the main function of hygiene products is washing, some also confer moisturizing and nourishing properties to the skin by containing ingredients that give softness and suppleness to the skin, eliminating the feeling of dryness after bathing.
9 no-charge cleaning agent
All cosmetic products whose main ingredient is water need to contain preservatives in order to maintain their stability throughout the expected post-opening time. The amount of preservative to be used is limited to maximum values that may be contained in the formulations
Hydration and nutrition
Coming out of the bath should be done to a soft towel and the excess water removed without rubbing the towel on the skin. In the following 3 to 5 minutes, moisturizing cream should be applied to the entire surface area of the baby’s skin, especially the most sensitized areas. Moisturizing creams should promote homeostasis10 and for that they should contain ingredients that provide the 3 main mechanisms of skin hydration: the humectants, which attract water to the superficial layers of the skin; the occlusives, which maintain the water levels in the stratum corneum11; and the emollients, which as skin conditioners maintain the skin’s softness, shine, and smoothness. Some also contain ingredients that contribute to the physiological mechanisms of the skin.
1the balance state of the skin
11 skin surface bed
Diaper changing is another care with special importance because the skin of the baby’s bottom and genital area are very sensitive and easily traumatized skin areas. As this is an area that remains occluded throughout the day, the effect caused by the presence of faeces and urine, such as increased humidity, pH and temperature, facilitate the proliferation of pathogenic microorganisms12 and consequently the development of diaper rash.
It is therefore very important to protect the baby’s skin. The use of products that contain ingredients that provide the barrier effect through their astringency, and simultaneously have soothing and anti-inflammatory functions, such as zinc oxide, is very important to reduce the friction caused by the contact of the diaper, the moisture and heat caused by the presence of feces and urine, with the skin of the baby’s bottom area. The product for diaper change, besides zinc oxide, should also contain ingredients that ensure the same mechanisms of hydration and nutrition of the skin mentioned above. The choice for products with different contents of zinc oxide should be made considering the severity of the erythema presented, and this content should increase with the severity of the erythema. In mild situations the zinc oxide content is lower and the resulting cream is almost transparent. When the erythema situation is already moderate, the zinc oxide content should be much higher and the appearance of the formulation is thick and white (greater barrier effect). In severe erythema situations the zinc oxide content more than doubles and the formulation remains white but fluid (to facilitate painless application).
Prevention of diaper rash requires that the choice of product be as appropriate to the situation as possible. Change your diaper whenever necessary. In case of longer trips or during the night use a more occlusive product with a greater barrier effect.
All formulations for baby skin care should be as allergen-free as possible, as these are the ones that most induce allergic reactions and sensitization in the skin. These are mainly present in products containing perfume. We all like a fragrant baby, but try to use a mild perfume or colognes, apply a few drops to the baby’s outer clothing avoiding contact with the skin.
12 microorganisms capable of causing diseases to living beings
Ana Cristina M. Correia Matos
PhD | Training Manager at Laboratório EDOL – Produtos Farmacêuticos, S.A.